Just breathe...

I have been running myself ragged these last couple of months actually. First work was really stressful and I was working a ton. Then I moved, and that has been surprisingly more stressful than I anticipated. So now, I always feel like I am never quite caught up. I have no routine. My workouts have suffered. I barely cook. I am just tired! All that being said, I think I have made a turning point in my medical career in the last month or so. I am not sure if it is because I am almost done with my intern year, or if there comes a point in all physicians life where they feel like they are getting it. I am taking responsibility for my patients and not just doing what the Attending says. I make my own decisions, and feel the repercusions of those decisions. For example, I just discharged a 40 year old woman with congestive heart failure. Her heart was pumping 1/3 as well as a normal heart, so she was admitted and an automated internal cardio defibrillator was placed. She was doing well and was discharged a day following the procedure (yesterday, my day off). Today I came into work and was dictating her discharge summary when I looked in the computer and she had been readmitted! Turns out, she had a massive stroke about 12 hours after discharge! She was now in the ICU. Oh boy, I freaked. I ran through everything in my mind to see what I missed. I talked to the Cardiologist who was also concerned. I went to see her in the ICU. I felt terrible for this poor woman, and also a real fear in how easily something like that can happen. There were no mistakes so far as I could see, but still, it is so sad to see in a person so young. She had been putting off this procedure too because she was scared to do it. It really bummed me out. It made me realize the importance in what I do everyday.
Then, we were driving to the store and we saw a homeless man passed out in his wheelchair at the offramp from the freeway. My first reaction, was look at that guy passed out there. Then Gary said: "You going to go check him out?" Well, damn...I guess so. That's who I am isn't it? Just then an ambulance pulled up, turns out some other folks were concerned about him too.

I have a pretty cool job, but I'm scared. For real.